Organization Formation as Epistemic Practice: The Early Epistemological Function of the American Medical Association

Abstract

This research explores how social actors adjudicate knowledge claims within intellectual environments where epistemic standards are contested. Through the case study of 19th century debates over cholera in the United States, I examine the strategies deployed by orthodox and homeopathic physicians in the struggle over medical knowledge during this "epistemic contest." The 1832 cholera epidemic ushered in a crisis for orthodox medicine, as epistemological standards for adjudicating medical knowledge claims became challenged and ill-defined. Failing to muster an effective cultural response to homeopathy, orthodoxy adopted an organizational strategy, forming the American Medical Association and offering professional membership as a proxy indicator of legitimate knowledge. The AMA created an organizational/intellectual space insulated from homeopathy, which translated into a concerted campaign to exclude homeopaths from government institutions and affected the nature of orthodox knowledge on cholera. This case reveals that epistemic contests are not waged by cultural means only; organizational practices form an integral part of actors' repertoires in adjudicating epistemological claims in practice.

The Love of Neuroscience: A Sociological Account

“…Either way, the way I understand SoE, many sociological studies have made contributions to it. Their empirical settings are diverse: medicine, sexuality, and psychiatry (Epstein 2007; Waidzunas and Epstein 2015; Whooley 2010, 2013, 2014), the German Stasi (Glaeser 2011), technological accidents (Downer 2011; Vaughan 1996), poverty knowledge (Rodríguez-Muñiz 2015), policymaking and evaluation (Breslau 1997), and the uses of measurement, quantification, and statistics (Espeland and Sauder 2007, 2016; Igo 2007; Schweber 2006). The most frequent empirical setting, though, is the epistemologies of social and natural science communities (Abbott 1990, 2001a, 2001b, 2016; Abend 2006; Au 2017; Keim 2016; Knorr Cetina 1999, 2011; Lamont 2009; Mallard, Lamont, and Guetzkow 2009; Steinmetz 2005a, 2005b, 2013), including their causal claims (Abend, Petre, and Sauder 2013; Vaidyanathan et al 2016).…”

Pandemics, policy, and the power of paradigm: will COVID-19 lead to a new scientific revolution?

“…Arguably given this history, Snow's work should have been viewed not as the absence of science, but as competing science, developed by a recognized master of the craft. In this sense, The Lancet editors’ assessment represented a fundamental error in the core task of scientific epistemology: defining the criteria by which legitimate knowledge may be distinguished from unfounded opinion [18] . Why did this error occur?…”

“…With further confirmation of Vibrio cholera in the work of Robert Koch and similar discoveries about rabies, anthrax, tuberculosis, and diphtheria at the end of the 19th century, the benefits of biomedical expertise began to capture public attention [26] . Biomedicine, which had competed with other medical disciplines for political influence since the 1830s, had won out [ 18 , 26 ].…”

“…In the early 20 th century, reliance on what medical education reformer Abraham Flexner described in 1915 as “definite sciences—anatomy, physiology, pharmacology, etc.” [ 27 , para. 10] became the goal of medical schools and an increasingly powerful American Medical Association [ 18 , 28 ]. By the 1920s, the image of physicians as the experts uniquely qualified to evaluate, treat, and provide counsel on human ailments was firmly established in the American psyche [ 26 , 29 ].…”

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